1. Field of the Invention
The present invention relates to an examination system suitable for an X-ray photographic system, for example, for taking an order from a doctor for the taking of an X-ray photograph (radiograph) and for performing X-ray photography (radiography), to an image processing apparatus and method, and to a medium therefor.
2. Description of the Related Art
An “X-ray photographic apparatus” refers to an apparatus for detecting X-rays, which have been transmitted through a patient, to form an image. This image is formed by representing differences in the transmittance of each type of the tissue structure in the body of the patient and the thickness thereof as a photography density. It is important for a good X-ray image that as much information as possible be displayed in a readily visible manner. The position of the patient, the direction of X-ray irradiation, photographic conditions, etc., exert large influences thereon. Accordingly, when a doctor orders an X-ray photograph be taken, X-ray information such as the area to be X-rayed, the X-raying directions, the X-raying methods, etc., is typically specified together with patient information such as the name and the ID number of the patient. The information is then sent to a technician, and the X-raying is performed. If a plurality of X-ray photographs are to be taken, X-ray photographic request information, together with the patient information such as the name and the ID number of the patient, is included in the X-ray photograph order, for example, “chest portion A→P,” “chest portion R→L,” “cervical vertebra R→L,” or “cervical vertebra A→P.”
FIG. 12 shows an X-ray photographic system in which an X-ray photographic apparatus and an X-ray generation apparatus are combined, which shows an example contrasted to the present invention. In FIG. 12, reference numeral 100 denotes an X-ray tube for emitting X-rays. Reference numeral 101 denotes an X-ray generation apparatus. Reference numeral 102 denotes an operation and display section of the X-ray generation apparatus, for performing operation of the X-ray generation apparatus. These are usually collectively termed an “X-ray generation apparatus”. On the other hand, the X-ray photographic apparatus comprises a standing position sensor unit 103 capable of performing X-ray photography of a patient in a standing position, a recumbent position sensor 105, an X-ray photographic system control section 107 for controlling this sensor, and an operation and display section 108 of the X-ray photographic system. Also, reference numeral 104 denotes a standing position sensor panel, and reference numeral 106 denotes a recumbent position sensor panel. The electrical charge corresponding to the amount of transmitted X-rays, detected by the standing position sensor panel 104 and the recumbent position sensor panel 106, is converted for analog into digital form and is input as an electronic image to the X-ray photographic system control section 107. Also, reference numeral 110 denotes a network which is connected to an imager 111.
When patient reception has been completed, a patient proceeds to a section of a corresponding examination department (for example, brain surgery, internal medicine, surgery, orthopedic surgery, etc.), and the patient's illness is diagnosed. For example, there are cases in which, in order to examine cervical vertebrae in a surgery department, it is desirable to see X-ray images of cervical vertebrae taken from four different directions. Examples of the four directions of the cervical vertebrae include “cervical vertebrae, front,” “cervical vertebrae, foramen,” “cervical vertebrae, side,” and “cervical vertebrae, right rear oblique region.”
The “cervical vertebrae, front” is obtained by a method in which the X-ray photograph is taken when the patient is made to stand facing the X-ray generation apparatus. Adjustments are made so that the forehead is horizontal to the standing position sensor panel 104, and the angle and position of the X-ray tube 100 are adjusted so that X-rays can be emitted toward the fourth cervical vertebra of the patient. In a method for properly positioning the “cervical vertebrae, foramen,” the patient is made to lie supine on the recumbent position sensor unit 105, the mouth is opened to the fullest, the line connecting the head in the median plane to the external ear foramen and the line connecting the base of the nose to the external ear foramen are made perpendicular to each other, and the X-ray tube is set to be perpendicular to the recumbent position sensor panel 106 so that the radiation focus is at the head in the median plane. In a method for properly positioning the “cervical vertebrae, side,” the patient is made to stand facing 90 degrees away from the standing position sensor unit 103, the jaw is made to project forward slightly, the shoulders are made to lower, and the X-ray focus becomes incident on the fourth cervical vertebra. In a method for properly positioning the “cervical vertebra, right rear oblique region,” the standing position sensor panel 104 and the patient form an angle of 50°, with the shoulder being the center; then, the jaw is made to project forward slightly, and the shoulders are made to lower.
A doctor writes the order for the X-ray photographing of the cervical vertebra in four directions on a radiology record card. At this time, the photographing order is written in the order in which the doctor wishes to subsequently view the images. For example, the order may be “cervical vertebra, front”→“cervical vertebra, foramen”→“cervical vertebra, side”→“cervical vertebra, right rear oblique region.” Alternatively, there are cases in which the photographing order is indicated by “cervical vertebra, four directions.” At this time, the meanings indicated by “cervical vertebra, four directions” may differ depending on the examination department (i.e., in the brain surgery department, “cervical vertebra, front”→“cervical vertebra, side”→“cervical vertebra, anteflexion”→“cervical vertebra, retroflexion”), the sequence may differ from doctor to doctor, and the sequence may differ depending upon the facilities.
The patient, with this radiology record card in hand, proceeds to the radiotherapy department and submits it to the receptionist. When it is the patient's turn to be X-rayed, the patient is taken to a room in which the X-ray photographic system in FIG. 12 is disposed. The technician first examines the patient information such as the ID number and the name written on the radiology record card, confirms the identity of the patient and then inputs this data by using the operation and display section 108. This data is required to confirm a match between the images and the patient and to assist the doctor in interpreting the images. Next, after the technician reads the X-ray photography order written on the radiology record card, the patient is correctly positioned; at the operation console 102 of the X-ray generation apparatus, the tube voltage, the tube current, and the irradiation time or the photo-timer are set; and in the operation console 108 of the X-ray photographic apparatus, image processing parameters, the imager 111 of the transfer destination, etc., are set to perform X-ray photography.
First, a case is described in which X-ray photography is conducted in the order as written on the radiology record card. The technician, after reviewing the radiology record card, performs X-ray photography of the “cervical vertebra, front.” The patient is made to stand facing the X-ray generation apparatus, and adjustments are made so that the forehead is parallel to the standing position sensor panel 104. Also, the angle and position of the X-ray tube 100 are adjusted so that X-rays can be emitted toward the fourth cervical vertebra of the patient. At this time, the position of the X-ray tube 100 is such that X-rays are emitted toward the fourth cervical vertebra of the patient from 15° below the fourth cervical vertebra. Examples of the X-ray photographic conditions are as follows: the distance between the standing position sensor panel 104 and the X-ray tube 100 is 120 cm, the tube voltage of the X-ray tube 100 is 72 kV, the tube current is 160 mA, the irradiation time is 56 msec, and the cross grid and the tube are focused on a small area. After the photographic preparations are completed and photography is possible, the irradiation switch in the vicinity of the operation and the display section 102 of the X-ray generation apparatus is pressed, and X-rays are emitted from the X-ray tube 100 to the standing position sensor unit 103. X-rays emitted from the X-ray tube 100 pass through the patient and are converted into electricity of various amounts by the standing position sensor panel 104. This electricity is then amplified by an amplifier, signal processing, such as analog/digital conversion, is performed thereon, and the result is obtained as a digital image. The image input to the control section 107 of the X-ray photographic system is subjected to various image processings, such as gradation processing or highlight processing, and is displayed on the operation and display section 108 of the X-ray photographic system. The technician examines the image, and if it is necessary to retake the X-ray photograph, a rephotographing key is then pressed to retake the image. If it is not necessary to retake the X-ray photograph, then the technician performs second and subsequent X-ray photography in a similar manner.
X-ray photography is then performed for “cervical vertebra, foramen,” “cervical vertebra, side,” and “cervical vertebra, right rear oblique region.” When the photography of the “cervical vertebra, four directions” is completed, the termination key is pressed to transfer the four obtained images to the imager 111 via the network 110 so that the images are displayed on film, and these images are passed on to the doctor for examination. However, since the X-ray photography of the “cervical vertebra, foramen” for the second photography is performed by the photographic apparatus with the patient in a recumbent position, the proper positioning of the patient is time-consuming, causing problems in that this is burdensome and the rate at which X-rays may be taken is low.
Next, a case is described in which the X-ray photographic technician performs X-ray photography in a sequence in which it is easier to take the X-rays, regardless of the sequence in which the doctor has requested them. It is common practice for the technician to take the X-rays with as little effort as possible and in a sequence in which the burden on the patient is minimized. Since the recumbent position sensor unit 105 is used for only the “cervical vertebra, foramen,” and at this time the patient must be moved a great deal and the position of the X-ray tube must be substantially changed, it is efficient for X-ray photography other than the “cervical vertebra, foramen” to be performed continuously to reduce the burden on the patient. For example, X-ray photography is performed in the sequence “cervical vertebra, front”→“cervical vertebra, right rear oblique region”→“cervical vertebra, side”→“cervical vertebra, foramen.” In this case, after X-ray photography of the “cervical vertebra, four directions” is terminated, the photographs are transferred via the network 110 in the sequence in which they were taken by the imager 111. Consequently, they must be transferred to film and must be rearranged in the sequence in which the doctor wishes to examine them to perform diagnosis.
In recent years, there have been cases in which networks are constructed with the intra-hospital information systems called “HIS” and radiology information systems called “RIS,” and requested data from the diagnosis department and patient information from the HIS server are transmitted via the network and are input. Even in this case, the above-described problems remain.
In a manner as described above in the first X-ray photography situation, there is a problem in that proper positioning cannot be performed efficiently when the predetermined photographic sequence is inconvenient for the technician; therefore, the photographing efficiency is decreased, and the burden on the patient is substantial. In the second X-ray photography situation, effort is subsequently required to rearrange the sequence of the image films into that which the doctor wishes to see, and this is also inconvenient. Another problem is that there is no effective means to confirm the order of the part currently being X-rayed and to confirm which part is photographed last. In addition, a problem arises in that when an X-ray must be retaken, this retake must be performed before the next part is X-rayed.
As described above, there are problems in that when X-ray photography is to be performed in a requested sequence, the photographing efficiency may be decreased, and in that the rearrangement of the sequence to that in which the doctor will view the images after the X-ray photographs are taken is very complicated. In addition, problems occur in that it cannot be confirmed which part in the photographing order is currently being photographed, and in that when the image is blurred, retake cannot be performed quickly. Such problems occur not only in the above-described examination apparatus, but also in other photography, for example, in a case in which images from a consumer digital camera are printed out.